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General NPI Number Information
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NPI Number | 1396181798
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Entity Type | Organization
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Legal Business Name | CHARLES CIFIZZARI
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Dates
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Enumeration Date | 05/13/2013
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Last Update Date | 05/13/2013
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Provider Practice Location Address
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Address Line | 11711 HARVESTDALE DR
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-7414
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Country | US
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Telephone | 540-445-1122
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Fax |
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Provider Business Mailing Address
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Address Line | 11711 HARVESTDALE DR
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City | FREDERICKSBURG
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State | VA
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Zip | 22407-7414
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Country | US
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Telephone | 540-445-1122
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHARLES CIFIZZARI
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Credential |
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Telephone | 540-445-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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